Joo Young-Hoon, Sun Dong-Il, Cho Kwang-Jae, Park Jun-Ook, Kim Min-Sik
Department of Otolaryngology-HNS, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seocho-gu Panpo-dong 505, Seoul 137-040, Korea.
Eur Arch Otorhinolaryngol. 2011 Feb;268(2):289-94. doi: 10.1007/s00405-010-1367-z. Epub 2010 Aug 19.
The purpose of this study was to examine functional and surgical outcomes after fasciocutaneous free flap reconstruction of the hypopharynx. A retrospective review of the records of 48 consecutive patients that underwent hypopharyngectomy and reconstruction using fasciocutaneous free flaps between 1996 and 2009 was performed. Flap donor sites included the radial forearm (n = 42), anterolateral thigh (n = 5), and lateral thigh (n = 1). There was no perioperative mortality, and the free flap survival rate was 95.8%. Five (10.4%) patients developed a postoperative pharyngocutaneous fistula. In three (6.3%) patients a stricture developed during the postoperative period. Forty-four (92%) patients were decannulated and maintained their voice. Forty-four (92%) patients were able to take oral nutrition, although 4 (8%) needed additional PEG-tube feeding. Five-year overall and disease-specific survival rates were 56 and 61%, respectively. Functional reconstruction of extensive laryngohypopharyngeal defects can be achieved using fasciocutaneous free flaps with favorable functional and surgical results.
本研究的目的是探讨下咽游离筋膜皮瓣重建术后的功能及手术效果。对1996年至2009年间连续48例行下咽切除术并采用游离筋膜皮瓣重建术的患者病历进行回顾性分析。皮瓣供区包括桡侧前臂（n = 42）、股前外侧（n = 5）和股外侧（n = 1）。围手术期无死亡病例，游离皮瓣成活率为95.8%。5例（10.4%）患者发生术后咽皮瘘。3例（6.3%）患者术后出现狭窄。44例（92%）患者拔管并保留了嗓音。44例（92%）患者能够经口进食，尽管4例（8%）需要额外的经皮内镜下胃造口管饲。5年总生存率和疾病特异性生存率分别为56%和61%。采用游离筋膜皮瓣可实现广泛喉下咽缺损的功能重建，功能和手术效果良好。
